Facing surgery is daunting for anyone. What may be considered simple by some is nerve racking none the less. As a new experience, an operation comes with fears of both the known and the unknown.  As a nurse dedicated to pain management, I found that my expectations of healthcare professionals in charge of my care carried a heightened level of trust, along with the wiliness to give up control (those who know me will confirm that this is a hard task). This summer, I faced both challenges and fears.

I had a breast cyst that grew rapidly over a few weeks. Even though I have had cysts before, it was a scary time. I saw my physician quickly and had my annual mammogram along with an ultrasound.  The interventional radiologist and ordering physician concurred that is was most likely benign (not cancer). I know both of these clinicians and have full trust in them. This provided some comfort. A referral to a breast surgeon was recommended.  A 10 day course of antibiotics were started, as it looked like the cyst was infected. This all happened in a matter of a few days.

I saw the surgeon shortly after the antibiotic course was completed. I had never met her before. Respected colleagues gave her a “thumbs up” review before my appointment. I was nervous and amused at our first meeting.  She was younger than me, had a friendly, professional demeanor, and did not assume things about my level of knowledge on breast disease.  (Nurses commonly are expected to know everything even if not within our specialty). She spent time with me and did not make me feel that she was rushed with a busy schedule.  She reviewed both benign and malignant breast disease (aka cancer) while reassuring me that she felt we were dealing with benign sebaceous cysts. Of course, it would be sent for pathology testing for verification.

A surgical plan was made. I would be scheduled for same day surgery (SDS) within the next week; monitored anesthesia care (MAC) would be used and a short recovery time before being releasef to go home.  Time off from work would be at least five (5) days, so a Wednesday was chosen. Only three (3) days off plus the weekend would be needed. The wearing of a support bra 24/7 was required (UGH).  I was then asked if I had any questions.

Pain nurse mode kicked in. My question was simple. Will you plan to infiltrate the surgical area with a local anesthetic too?  I have had past experience with MAC during a colonoscopy, so no worries there. Knowing that pain messaging will occur without a local anesthetic blockade, I needed reassurance. Her response to me was priceless. “Of course, I will be also using a local anesthetic to the wound”.  Okay, I was smiling now, and more convinced that she was the surgeon for me!

The day of surgery was scary and interesting at the same time. The nursing staff in SDS was welcoming, organized, and informative. I did not tell them that I was a nurse, yet my “tell” gave it away when they performed a baseline pain assessment. They used local anesthetic before inserting my IV; this experience was a breeze. Later, a couple of nurses came back to ask me if I used to work there as my name was familiar to them.  You see, I did work at the older hospital as the pain nurse specialist. They remembered being taught by me and some remembered my seeing patients on their units. That was humbling and comforting.

I was introduced to the nurse who would be circulating in the operating room (OR); she escorted me there, talking with me while she navigated my stretcher through the hallway. Once in the OR, I was assisted to the OR table; warm blankets were placed on me and pillow support to my knees and head were provided. I was introduced to the anesthesiologist (shook his hand) as well as the surgical team, already scrubbed in and ready to go. Lastly, my breast surgeon arrived, greeted me good morning, verified the surgical site and told me she would see me again in recovery. All these activities were comforting and helped to lower my anxiety of an unknown personal experience.

Promises were kept. I woke up while being transported to recovery. I honestly do not remember moving from the OR table back to the stretcher. I was greeted with a new friendly face (my recovery nurse) who gently asked, “Do you need anything?”  Now you can LOL! I asked for an ice pack to place on my surgical wound. Orders were received and my request was honored. Use of non-drug therapy was started as part of my integrative (personalized) pain care. I can honestly tell you that the ice pack and the willingness to offer helped me tremendously.

Graham crackers and soda were also offered as I became more alert. I asked for ginger ale, as I know ginger has medicinal properties that decrease nausea and inflammation. They did not have ginger snaps, so I suggested they consider this option in the future. Another integrative measure was started, and a pain assessment was performed. It never rose above 4/10 which is low moderate and stayed mostly in the mild ranges with rest or with movement.

Prior to my release, I did ask if I could be given my first dose of pain medication, which I would be taking post-operatively while at home. They obliged without resistance. Though my pain was low, I did not want it to rise before my prescription could be filled. This worked in my favor, as it took about 1 hour before the prescription would be ready even though electronically sent before my discharge.

I was blessed that two (2) of my respected nurse colleagues on staff made the time to visit with me when in recovery.  Knowing friends are looking out for you makes a difference. They told me that they had tried to see me before surgery but did not get there in time. I was okay with that as I was in good hands.

The overall result was a positive surgical experience. My acute pain after surgery was easily managed during and after my hospital stay. I kept using ice packs for the first 2 days with an occasional hydrocodone. I took mostly Tylenol or Aleve (alternated) for about 1 week, if that. My pain never rose above 4/10. Honestly, the worse part was wearing a bra 24/7 for 6 weeks post operatively (the girls like their freedom).

When I met with my breast surgeon for the post-operative exam, I did make sure that I shared my positive surgical experience, which included her wonderful care. I mentioned that my recovery was relatively easy. Her response was: “Your positive outlook played a big role”.  Perhaps.  I think using comprehensive, integrative pain care played a big role along with a caring, responsive healthcare team.

……and yes, the pathology report confirmed benign, sebaceous cysts with some inflammatory cells. Only the scar remains.

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